Chapter 14 : Biological and chemical terrorism : a unique threat

The prospect of chemical or biological terrorism, especially an event that causes mass casualties (i.e., a weapon of mass destruction) poses a great challenge to the U.S. health care system. The use of infectious organisms or toxic compounds by terrorist can have immediate and long-term effects. But even if our understanding of terrorism is inchoate, it is also important to keep the real risks in perspective. The terrorist operates in a diferent world than state-run military, and the contrast is especially important when it comes to developing chemical or biological weapons. Past experience and the nature of chemical or chemical or biological agents suggest that terrorists will rely upon conventional explosives. Some large casuality events could result, however from the application of large quantities of toxic nerve agents, or efficiently aerosolized pathogens. In such cases, hospitals and other emergency health care facilities may be forced to make stark choices in triaging patients. Given the heightened awareness of the real or perceived threat of chemical or biological terrorism in today's society, it is also likely thet mass psychogenic illness may present itself in a given population. Distinguishing such events with actual cases of biological and chemical terrorism may be quite difficult, at least early on (AU)